EP0825184B1

EP0825184B1 - Heterocyclic derivatives as platelet aggregation inhibitors

Info

Publication number: EP0825184B1
Application number: EP97117909A
Authority: EP
Inventors: Stuart Dennett Mills
Original assignee: AstraZeneca AB
Current assignee: AstraZeneca AB
Priority date: 1993-03-29
Filing date: 1994-03-28
Publication date: 2001-06-20
Anticipated expiration: 2014-03-28
Also published as: DE69411900D1; DE69427548D1; EP0825184A1; EP0691959A1; GB9406143D0; SK120895A3; ES2119184T3; DE69411900T2; NZ262941A; CZ250995A3; GR3027751T3; WO1994022834A1; CN1120334A; ATE168678T1; FI954616A; US5556977A; IL109144A0; BR9406613A; ES2159798T3; KR100231089B1

Abstract

RS 3-Methyl-4-Ä4-(4-pyridyl)piperazin-1-ylÜphenoxybutyric acid and metabolically labile ester or amides thereof, and pharmaceutically acceptable salts thereof useful as an inhibitor of the binding of fibrinogen to glycoprotein IIb/IIIa.

Description

The present invention relates its to a heterocyclic derivative which inhibits cell adhesion (for example, platelet aggregation), to processes for preparation and to pharmaceutical compositions containing it.
A variety of diseases involve cell adhesion during their development. For example, platelet aggregation is involved in the formation of blood thrombi, which can lead to diseases such as thrombosis, (eg stroke and thrombotic events accompanying unstable angina and transient ischaemic attack), myocardial infarction, atherosclerosis, thromboembolism and reocclusion during and after thrombolytic therapy.
It is widely believed that the platelet membrane glycoprotein IIb/IIIa (GPIIb/IIIa) mediates platelet aggregation. Adhesion molecules such as fibrinogen and von Willebrand Factor are believed to bind to GPIIb/IIIa sites on adjacent platelets and thereby cause them to aggregate. Other adhesion molecules which are known to bind to the GPIIb/IIIa are fibronectin, vitronectin and thrombospondin.
Surprisingly, as a result of random screening, the ability to inhibit platelet aggregation and to inhibit the binding of fibrinogen to GPIIb/IIIa has now been found to be possessed by certain heterocyclic derivatives containing a 4-[(4-pyridyl)piperazin-1-yl or related group.
According to one aspect, therefore, the present invention provides a compound RS 3-methyl-4-[4-(4-pyridyl)piperazin-1-yl]phenoxybutyric acid or a metabolically labile ester or amide therof or a pharmaceutically acceptable salt thereof.
Without wishing to be bound by theory, it is believed that the nitrogen atom in the pyridyl group functions as a replacement for the strongly basic guanidine group in arginine. The function of the nitrogen atom which is attached to pyridyl in the group represented by M² is believed to be to contribute to the ability of the nitrogen atom in the pyridyl group to function as a base. For example a 4-(4-pyridyl)piperazin-1-yl group, the nitrogen atom in the piperazin-1-yl group is believed to contribute to the ability of the nitrogen atom in the pyridyl group to function as a base as shown below:-
Examples of metabolically labile ester derivatives of a carboxy group are esters formed with alcohols such as (1-6C)alkanols, for example methanol, ethanol, propanol and isopropanol; indanol; adamantol; (1-6C)alkanoyloxy(1-4C)alkanols such as pivaloyloxymethyl; glycolamides; (S-methyl-2-oxo-1,3-dioxol-4-yl)methyl alcohol; and (1-4C)alkyloxycarbonyl(1-4)alkanols. It will be appreciated that compounds of formula I in which Z¹ is hydroxy may form internal esters.
Examples of metabolically labile amide derivatives of a carboxy group include amides formed from ammonia and amines such as (1-4C)alkylamine, for example methylamine, di(1-4C)alkyl amines, (1-4C)alkoxy(1-4C)alkylamines such as methoxyethyl amine, phenyl(1-2C)alkylamines such as benzylamine; and amino acids such as glycine or an ester thereof.
Particular pharmaceutically acceptable salts include, for example, salts with acids affording physiologically acceptable anions, such as salts with mineral acids, for example a hydrogen halide (such as hydrogen chloride and hydrogen bromide), sulphuric add or phosphoric acid, and salts with organic acids, for example trifluoroacetic acid. Other pharmaceutically acceptable salts include, for example salts with inorganic bases such as alkali metal and alkaline earth metal salts (for example sodium salts), ammonium salts, and salts with organic amines and quaternary bases forming physiologically acceptable cations such as salts with methylamine, dimethylamine, trimethylamine, ethylenediamine, piperidine, morpholine, pyrrolidine, piperazine, ethanolamine, triethanolamine, N-methylglucamine, tetramethylammonium hydroxide and benzyltrimethylammonium hydroxide.
According to another aspect, the invention provides a process for preparing RS 3-methyl-4-[4-(4-pyridyl)piperazin-1-yl]phenoxybutyric acid or a metabolically labile ester or amide thereof, or a pharmaceutically acceptable salt thereof which comprises
(A) reacting a compound of formula:
or an acid addition salt thereof with a compound of formula:
in which U¹ is a leaving atom or group. Examples of values for U¹ include halogen, such as chlorine or bromine, and hydrocarbylsulphonyloxy, such as methanesulphonyloxy and p-toluenesulphonyloxy. When the group in X¹ to which U¹ is attached is a carbonyl group, U¹ may also represent a hydroxy group or a reactive derivative thereof. Examples of reactive derivatives of a hydroxyl group include acyloxy groups such as acetyloxy, and groups formed in situ by reacting a compound of formula III in which U¹ is hydroxy with a peptide coupling reagent. Examples of peptide coupling reagents include carbodiimides such as 1,3-dicyclohexylcarbodiimide (DCC), preferably in combination with 1-hydroxybenzotriazole hydrate (HOBT).Examples of add addition salts include, for example the hydrochlorides.The reaction may conveniently be effected at a temperature in the range of from -10 to 120 °C, preferably from 10 to 100 °C. Suitable solvents include, for example, ethers such as tetrahydrofuran, amides such as dimethylformamide, nitriles such as acetonitrile, halogenated hydrocarbons such as dichloromethane and alcohols such as ethanol or isopropanol.In some circumstances, for example when an acid addition salt of a compound of formula II is used as starting material, or when the compound of formula II is relatively unreactive, the reaction may advantageously be performed in the presence of a base. Examples of suitable bases include tertiary amines, such as triethylamine, and alkali metal hydroxides, carbonates and bicarbonates, such as sodium or potassium hydroxide, carbonate or bicarbonate. When the compound of formula II is relatively unreactive a strong base such as an alkali metal hydride, for example potassium hydride, may conveniently be used.
(B) decomposing an ester of formula:
in which R²⁰ is a carboxyl protecting group. R²⁰ may be any conventional carboxyl protecting group that may be removed without interfering with other parts of the molecule. Examples of carboxyl protecting groups include (1-6C) alkyl groups (such as methyl, ethyl, propyl or t-butyl), phenyl and benzyl, the phenyl moiety in any of which may optionally bear 1 or 2 of halogeno, (1-4C)alkyl, (1-4C)alkoxy or nitro.The decomposition may be carried out using any one or more of the conventional reagents and conditions known in the art for converting carboxylic esters into carboxylic acids. Thus, for example, the decomposition may conveniently be performed by base catalysed hydrolysis, for example by using an alkali metal hydroxide such as lithium, potassium or sodium hydroxide, or a tertiary amine such as triethylamine in the presence of water. The base catalysed hydrolysis may conveniently be performed in the presence of a solvent such as an alcohol, for example methanol or ethanol, or an ether such as tetrahydrofuran or dioxan. Alternatively the decomposition may be carried out by acid catalysed hydrolysis, for example using aqueous acetic acid or trifluoroacetic acid. The temperature is conveniently in the range of from -10 to 100°C, for example from 10 to 50°C. When the alcohol residue is t-butyl, this may also conveniently be removed by heating, for example at a temperature in the range of from 80 to 150°C, alone or in the presence of a suitable diluent such as diphenylether or diphenylsulphone. A benzyl group may conveniently be removed by catalytic hydrogenation, for example by hydrogenation in the presence of palladium on carbon at a temperature in the range of from -10 to 100°C in the presence of a solvent such as an alcohol, for example methanol or ethanol.
(C) Reacting a compound of formula:
in which U³ is a leaving atorn or group, with a compound of formula:
or an acid addition salt thereof. Examples of values for U³ include halogen, such as chlorine or bromine, and cyano.Examples of add addition salts include, for example the hydrochlorides.The reaction may conveniently be effected at a temperature in the range of from -10 to 120 °C, preferably from 10 to 100 °C. Suitable solvents include, for example, ethers such as tetrahydrofuran and dioxan, amides such as dimethylformamide, nitriles such as acetonitrile, halogenated hydrocarbons such as dichloromethane, alcohols such as ethanol and water.In some circumstances, for example when an acid addition salt of a compound of formula VIII is used as starting material, the reaction may advantageously be performed in the presence of a base. Examples of suitable bases include tertiary amines, such as triethylamine, and alkali metal hydroxides, carbonates and bicarbonates, such as sodium or potassium hydroxide, carbonate or bicarbonate.
(D) reacting a compound of formula
with the appropriate compound of formula
or a reactive derivative of the hydroxy thereof (such as a halide, for example a bromide), in which X^2c is a hydroxy group, or a reactive derivative thereof (such as a halide).
The reaction is conveniently performed in the presence of a strong base, such as an alkali metal hydride, for example, sodium hydride. Suitable solvents include amides, such as dimethylformamide. The reaction is conveniently performed at a temperature in the range of from 0 to 100 °C.
The intermediates used in the aforementioned processes are known or may be prepared by methods analogous to those known for the preparation of known compounds.
Thus, the compounds of formula IV may be prepared by methods analogous to processes (A), (C) and (D) herein, but starting from the appropriately protected starting materials.
The compound may be converted into pharmaceutically acceptable salts and/or metabolically labile esters or amides thereof by methods well known in the art. For example, a pharmaceutically acceptable salt may be formed by reacting a compound of formula I with an acid capable of affording a physiologically acceptable anion, or a base capable of affording a physiologically acceptable cation. A pharmaceutically acceptable metabolically labile ester or amide may be formed respectively by esterifying a compound of formula I using a conventional technique, or reacting an acid, or a reactive derivative thereof with the appropriate amine.
The ability of the compound to inhibit platelet aggregation may be demonstrated using a standard test (a) based on that described by Born (Nature, 1962, 194, 927-929) and involving:
(i) aggregating human, citrated, platelet-rich plasma by addition of adenosine diphosphate so as to generate a dose-response curve;
(ii) generating a dose-response curve for ADP stimulated platelet aggregation in the presence of increasing arnounts of a test compound (generally in the range 10^-5M to 10^-10M); and
(iii) calculating a pA₂ value indicating potency of platelet aggregation inhibition for the test compound, averaged over several concentrations, from the calculated 50% response value for ADP aggregation in the presence and absence of the test compound.
Test (a) may be modified so as to assess the effects of a test compound ex vivo on the aggregation of human blood platelets after administration of the test compound to a laboratory animal, such as a rat, rabbit, guinea pig, mouse or dog. For example, groups of four male, tasted Alderley Park Wistar rats are orally dosed with a test compound or appropriate vehicle, and at suitable time intervals (1,3,5 and 8 hours after dosing) animals are anaesthetised with fluothane and bled by heart puncture. Blood is collected into 3.2% citrate (1 part to 9 parts whole blood) and platelet poor plasma (ppp) prepared by centrifugation (4500 x g for 10 min).
Human blood is collected into 3.2% trisodium citrate (1 part to 9 parts whole blood) and centrifugated (200 x g for 15 min) to produce platelet rich plasma (prp).
Equal volumes (125µl) of rat ppp and human prp are mixed together, ADP added, and the whole incubated (37°C) and stirred (900 rpm) in a BioData platelet aggregometer. Aggregation is induced with ADP and agonist EC₅₀ values calculated for human prp/rat ppp mixtures from animals dosed with test compound or vehicle. A mean concentration ratio (concentration of ADP required to cause a 50% aggregation response in human prp/rat ppp mixtures from animals dosed with antagonist, divided by the concentration of ADP to cause 50% aggregation in human prp/rat ppp mixtures from animals dosed with vehicle) is calculated at each time point.
The ability of the compounds of formula I to inhibit binding of fibrinogen to GPIIb-IIIa may be demonstrated using the following standard test (b) involving:
(i) Preparation of human platelet lysates.
Platelet rich plasma (PRP) is harvested by centrifugation (1000 rpm, 15 mins) of whole blood anticoagulated with acid citrate dextrose (trisodium citrate 85mM, citric acid 70mM, d-glucose 110mM) 1 part to 6 parts blood. Prostacydin (PGl₂, 1µM) is added to the PRP before centrifugation (2400rpm, 15mins) and the resulting pellet is resuspended in modified Tyrodes' solution (NaCl 130mM, KCl 26mM, NaHCO₃ 12mM, NaH₂PO₄ 0.5mM, MgCl₂ 1mM, CaCl₂ 20mM, Glucose 12mM, HEPES 5mM) containing bovine serum albumin 3.5g/L, PGl2 1µM and hirudin 0.5U/ml. The platelet suspension is centrifuged (2400rpm, 15mins) and the resultant pellet resuspended in 500µl of lysis buffer (octyl glucoside 50mM, HEPES 10mM, NaCI 150mM, CaCl₂ 1mM, MgCl₂ 1mM, PMSF 1mM, NEM 10mM, leupeptin 0.1mM), agitated at 4°C for 15 minutes then centrifuged at 24000rpm, 15 mins. The supernatant is stored at 4°C and the pellet re-suspended in 500µl of lysis buffer. The centrifugation process is repeated a further 3 times, the pooled supernatants being stored at -70°C.
(ii) Receptor purification.
Glycoprotein IIb/IIIa is isolated from human platelet lysates using a 2ml peptide (KYGRGDS) coupled CNBr activated Sepharose affinity column. A 1.5ml volume of platelet lysate is placed on the column and allowed to stand overnight at 4°C. Buffer (30mls, octyl glucoside 25mM, HEPES 10mM, NaCI 150mM, CaCl2 1mM, MgCl2 1mM, PMSF 1mM, NEM 10mM, leupeptin 0.1mM) is passed through the column and 2ml fractions are collected throughout. GPIIb/IIIa is eluted with 12mls of buffer containing HHLGGAKQAGDV (2mg/ml, pH 7.5), the column is washed using 4mls buffer and the remaining GPIIb/IIIa eluted using 12mls buffer containing GRGDSPG (1mg/ml pH 7.5). The column is finally washed using 20mls of buffer and can be used for up to three such preparations. Fractions containing GPIIb/IIIa are identified using gel electrophoresis and immunoblotting, pooled and stored at -70°C.
(iii) GPIIb/IIIa ELISA
96 well microtitre plates are coated with 100µl purified human platelet fibrinogen receptor (GPIIb/IIIa) diluted in coating buffer (Tris-HCl 20mM, NaCl 150mM, CaCl₂ 1 mM, pH 7.4) and left overnight at 4°C. The plates are washed using washing buffer (Tris-HCl 50mM, NaCI 100mM, CaCl₂ 2mM, pH 7.4) and non-specific binding blocked by the addition of 200µl 2% BSA (2 hours, 30°C). The plates are washed prior to incubation (2 hours, 30°C) with 100µl biotinylated fibrinogen (10nm) containing either vehicle or test compound. The plates are washed, incubated with streptavidin (5µg/ml, 1 hour, ambient temperature), then washed again before the addition of 100µl biotinylated horse radish peroxidase (0.1µg/ml, 1 hour, ambient temperature). The plates are then washed and equal volumes of peroxidase substrate (3, 5, tetramethyl benzidine 0.4g/l) and H₂O₂ (0.02%) are mixed together immediately before addition of 150µl to each well. Colour is allowed to develop for 10-15 mins before optical densities are read at 650nM.

Abbreviations

PMSF: Phenylmethylsulphonylfluoride
HEPES: (N-[2-Hydroxyethyl]piperazine-N-[2-ethanesulphonic acid]
NEM: N-ethyl maleimide

The concentration of compound required to cause 50% inhibition of biotinylated fibrinogen binding is calculated and expressed as a pIC₅₀ (-log(IC₅₀)).
In general, test compounds showing activity in this test show a pIC₅₀ of greater than about 4.0.
The effects of each of the compounds of formula I exemplified herein in the above tests are given in the table below. Where a range of values is given, the compound has been tested more than once. A dash (-) signifies that a compound has not been tested.
As stated previously, the compound may be used in the therapy or prevention of diseases in which cell adhesion (especially platelet aggregation) is involved, for example venous or arterial thrombosis (e.g. pulmonary embolism, stroke and thrombotic events accompanying unstable angina and transient ischaemic attack), myocardial infarction, atherosclerosis, thromboembolism and reocclusion during and after thrombolytic therapy. The compound may also be useful for the prevention of reocclusion and restenosis following percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass graft. it will also be appreciated that the compound may be useful in the treatment of other diseases mediated by binding of adhesion molecules to GPIIb/IIIa, for example cancer.
According to another aspect, therefore, the invention provides a method of inhibiting platelet aggregation in a warm-blooded mammal requiring such treatment, which comprises administering an effective amount of RS 3-methyl-4-[4-(4-pyridyl)piperazin-1-yl]phenoxybutyric acid [the compound] or a metabolically labile ester or amide thereof, or a pharmaceutically acceptable salt.
According to yet another aspect, the invention provides a method of inhibiting binding of fibrinogen to GPIIb/IIIa in a warm-blooded animal requiring such treatment, which comprises administering an effective amount of the compound, or a metabolically labile ester or amide thereof, a pharmaceutically acceptable salt thereof.
According to a further aspect, the invention provides the use of the compound, or a metabolically labile ester or amide thereof or a pharmaceutically acceptable salt thereof for the manufacture of a medicarnent for the prevention or treatment of a disease involving platelet aggregation.
According to yet another aspect, the invention provides the use of the compound or a metabolically labile ester or amide thereof or a pharmaceutically acceptable salt thereof, for the manufacture of a medicament for the prevention or treatment of a disease involving binding of fibrinogen to GPIIb/IIIa.
In general, the compound will be administered for this purpose by an oral, rectal, topical, intravenous, subcutaneous, intramuscular or inhalation route, so that a dose in the range of from 0.01 to 50 mg/kg body weight will be given, depending upon the route of administration, the age and sex of the patient, and the severity of the condition to be treated.
The compound will generally be used in the form of a pharmaceutical composition comprising the compound or a pharmaceutically acceptable salt thereof as defined hereinabove , together with a pharmaceutically acceptable diluent or carrier. Such a composition is provided as a further feature of the invention and may be in a variety of dosage forms. For example, it may be in the form of tablets, capsules, solutions or suspensions for oral administration; in the form of cream or ointments or a transdermal (skin) patch for topical administration; in the form of a suppository for rectal administration; in the form of a sterile solution or suspension for administration by intravenous or intramuscular injection; in the form of an aerosol or a nebuliser solution or suspension, for administration by inhalation; and in the form of a powder, together with pharmaceutically acceptable inert solid diluents such as lactose, for administration by insufflation. Depending upon the route of administration, the composition may comprise, for example, for 0.1 to 99.9% by weight of the compound.
The pharmaceutical compositions may be obtained by conventional procedures using pharmaceutically acceptable diluents and carriers well known in the art. Tablets and capsules for oral administration may conveniently be formed with an enteric coating, for example comprising cellulose acetate phthalate, to minimise contact of the active ingredient with stomach acids.
The compound may be co-adminstrated or co-formulated with one or more agents known to be of value in diseases or conditions intended to be treated; for example a known platelet aggregation inhibitor (e.g. aspirin, a thromboxane antagonist or a thromboxane synthase inhibitor), hypolipidemic agent anti-hypertensive agent, thrombolytic agent (such as streptokinase, urokinase, prourokinase, tissue plasminogen activator and derivatives thereof), beta-adrenergic blocker or a vasodilator may usefully also be present in a pharmaceutical composition of the invention for use in treating a heart or vascular disease or condition.
In addition to their use in therapeutic medicine, the compound is also useful as pharmacological tools in the development and standardisation of test systems for the evaluation of the effects of adhesion molecules in laboratory animals such as cats, dogs, rabbits, monkeys, rats and mice, as part of the search for new therapeutic agents. The compounds of formula I may also be used because of their platelet aggregation inhibitory properties in helping to store blood and to maintain the viability of blood and blood vessels in warm-blooded animals (or parts thereof) under-going artificial extracorporeal circulation, for example during limb or organ transplants. When used for this purpose the compound a physiologically acceptable salt thereof, will generally be administered so that a steady state concentration in the range, for example, 0.1 to 10 mg. per litre is achieved in the blood.
The invention will now be illustrated by the following non-limiting Examples in which unless otherwise stated:-
(i) concentrations and evaporations were carried out by rotary evaporation in vacuo;
(ii) operations were carried out at ambient temperature, that is in the range 18-26°C;
(iii) column chromatography was carried out on silica (Merck Art. 9385) available from E Merck and Co., Darrnstadt, Germany; and on neutral alumina (ICN Alumina N, Akt. Ill or IV) available from ICN Biomedicals GmbH, D-3440 Eschwege, Germany;
(iv) yields are given for illustration only and are not necessarily the maximum attainable by diligent process development;
(v) proton NMR spectra were normally determined at 200 MHz or 250 MHz in dimethylsulphoxide-d₆ using tetramethylsilane (TMS) as an internal standard, and are expressed as chemical shifts (delta values) in parts per million relative to TMS using conventional abbreviations for designation of major peaks: s, singlet; m, multiplet; t, triplet; br, broad; d,doublet; and
(vi) ether refers to diethyl ether, THF to tetrahydrofuran, DMF to N,N-dimethylformamide, DMSO to dimethylsulphoxide, TFA to trifluoroacetic acid; HOBT to 1-hydroxybenzotriazole; and NBA to m-nitrobenzylalcohol.
(vii) Drying with PS paper refers to the use of Whatmans PS phase separating paper.

EXAMPLE 1 RS 3-Methyl-4-[4-(4-pyridyl)piperazin-1-yl]phenoxybutyric acid, trifluoroacetate

To a stirred suspension of 4-[(4-pyridyl)piperazin-1-yl]phenol (1.02g) in dry DMF (10rnl) was added sodium hydride (60% dispersion in mineral oil, 0.16g) and the mixture stirred for 1 hour at room temperature. To the resulting solution was added ethyl-4-bromo-3-methylbutyrate and the mixture stirred for 16 hours. Solvent was evaporated and the residue partitioned between water and dichloromethane. Insoluble material was removed by centrifugation. The organic layer was filtered through phase separating paper (Whatman IPS) and the residue was purified by flash chromatography on silica gel by elution with methanol/dichloromethane/concentrated ammonia (50/950/5) to give ethyl 3-methyl-4-[4-(4-pyridyl)piperazin-1-yl]phenoxybutyrate (0.27g) which was hydrolysed in methanol (3ml) and aqueous sodium hydroxide (1 N, 2ml) for 2 hours at room temperature. The solution was evaporated and the residue purified by reverse phase h.p.l.c (water/acetonitrile/0.1% TFA gradient) to give a glass which crystallised on trituration with ether to give the title compound (0.08g): m.p. 169-171°C; NMR(d₆DMSO) δ 13.45(1H,broad), 12.07(1H,broad) 8.27(2H,d), 7.28(2H,d), 6.9(4H,m), 3.80(6H,m), 3.16(4H,t), 2.45(1H,m), 2.37(1H,m), 2.12(1H,m), 1.0(3H,d); m/e 356(M+H)⁺; calculated for C₂₂H₂₅N₃O₄F₃. 0.5 H₂O: C, 55.2; H, 5.6; N, 8.9. Found: C, 55.3; H, 5.6; N, 8.7%.

EXAMPLE 2

Illustrative pharmaceutical dosage forms suitable for presenting the compounds of the invention for therapeutic or prophylactic use include the following, which may be obtained by conventional procedures well known in the art.
a)

Tablet I mg/tablet

Active ingredient 1.0

Lactose Ph. Eur. 93.25

Croscarmellose sodium 4.0

Maize starch paste (5%.w/v aqueous paste) 0.75

Magnesium stearate 1.0
b)

Tablet II mg/tablet

Active ingredient 50

Lactose 223.75

Croscarmellose sodium 6.0

Maize starch 15.0

Polyvinylpyrrolidone (5% w/v aqueous paste) 2.25

Magnesium stearate 3.0
c)

Tablet Ill mg/tablet

Active ingredient 100

Lactose 182.75

Croscarmellose sodium 12.0

Maize starch paste (5% w/v aqueous paste) 2.25

Magnesium stearate 3.0
d)

Capsule mg/capsule

Active ingredient 10

Lactose Ph. Eur. 488.5

Magnesium stearate 1.5
(e)

Injection mg/ml

Active ingredient (acid addition salt) 1.0

Sodium chloride 9.0

Purified water to 1.0ml

Claims

RS 3-Methyl-4-[4-(4-pyridyl)piperazin-1-yl]phenoxybutyric acid or a metabolically labile ester or amide thereof.
RS 3-Methyl-4-[4-(4-pyridyl)piperazin-1-yl]phenoxybutyric acid or a pharmaceutically acceptable salt thereof.
RS 3-Methyl-4-[4-(4-pyridyl)piperazin-1-yl]phenoxybutyric acid.
A compound as defined in any one of claims 1 to 3 for use in medical therapy.
A pharmaceutically composition comprising a compound as defined in any one of dairns 1 to 3 together with a pharmaceutically acceptable diluent or carrier.
Use of a compound, as defined in any one of claims 1 to 3 in the manufacture of a medicament for the prevention or treatment of a disease involving platelet aggregation.
Use of a compound, as defined in any one of claims 1 to 3 in the manufacture of a medicament for the prevention or treatment of a disease involving binding of fibrinogen to Glycoprotein IIb/IIIa.